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Hello all,I live in Provincetown, Cape Cod, MA, a resort town. Our state Dept of Health is reporting a bacterial Meningitis outbreak in the gay population in NYC and possibly in CA. Since bacterial Meningitis is easily spread by saliva, kissing, sharing a drink, and Boston & PTown are popular vacation spots, with many visitors from CA & NY it is suggested that we get a meningitis vaccination.

I got a meningitis shot this week & I was amazed that Medicare Part D paid for it, as it's expensive. I also got a new Pneumonia vaccine, as there are now 2 different kinds of pneumonia vaccines.Hugs from gay Provincetown, Deibster

ďAll HIV-positive MSM and all MSM, regardless of HIV status, who regularly have close or intimate contact with multiple partners, or who seek partners through the use of digital applications, particularly those who share cigarettes, marijuana or use illegal drugs, should visit their health provider to be vaccinated against invasive meningococcal disease,Ē

Though Philadelphia is only 90 miles from NYC and there is a lot of back and forth with the gay population for clubbing, etc. there have been no warnings from our city health department. There was one death here in March at Drexel University but the news reported it as an isolated case of a female student. Similarly though not ending in death there were several cases last year on the Princeton campus which, for those of you unfamiliar with this area, is exactly midway between the two cities.

There have been advisory information in local clinics that if you are a gay man/MSM who travels frequently to NYC you should discuss this with your provider about getting vaccinating, but emphasizing that there have been ZERO cases locally associated with the NYC outbreak.

I go to NYC once or twice annually and I have not been vaccinated, mostly because I don't hole up in gay bars in when I go. I suppose I should ask my doctor if he thinks I need one anyway.

The announcements from the NYC DPH were a year ago, in early spring of '13, and vaccinations continued into late spring in NYC & MA. The last I heard, they were stopping the vaccinations as there had been no new cases reported, in the NYC area, since February of '13.Hugs, Deibster

Brian and I were just reading up on bacterial meningitis. We were suppose to be in Florida this week, but things did not work out. Brian's parents and other family members have winter homes there-- all in the same town. We had never been down there when his aunt was there, so we have yet to see her house. She wanted us to stay with her.

We just learned she is in the hospital very ill with it. We would have arrived at her home last Friday, if we had gone like we planned. The info about transmission is conflicting. The NIH says you cannot contract it from casual contact, saying you need to be kissing, sharing drinks, etc. But, then it says those who've been in contact should consider prophylactic antibiotic therapy. They say it doesn't transmit as easily as a cold or flu. I was surprised they said only about 4,000 people are dx'd each year, with a 10% mortality rate. I thought there would be more cases.

4,000 in a country of 300 million obviously means it must not transmit easily. But, I know myself. I would be having all sorts of anxiety today that I was possibly infected. That's the only humor we could make of the situation. She's in really bad shape. We hope she recovers quickly with no lasting effects.

And note that last winter students at UC Santa Barbara were offered vaccinations after an outbreak similar to the one at Princeton.

LA Times from three days ago: Citing a recently identified uptick in potentially deadly meningococcal disease, the Los Angeles County Department of Public Health recommended Wednesday that men who have sex with men get a meningitis vaccination.

In one past, unrelated outbreak (old case), one guy was the bother in law of the other: it was possible to establish a timeline and determine that symptoms showed up 24 h hours after infection and death (at hospital, under profersionnal care) in 24 h. Infection to death : 48 h ... Link to MSM group could not be established in that 'family' case

Incidently, our (HIV) clinic is currently doing tongue smear test on at-risk patient. Found the bacteria in 25% of tested people. (only a very small fraction will develop the virulent/deadly form).

Outbreaks in young male communities (such as the military) is not uncommon and the military get shots

I hope your Aunt comes out of it ok. Swelling of the brain or surrounding tissue is not something you want to mess around with.

My issue was actually viral encephalitis, not meningitis, I just always get them messed up, probably since my brain almost exploded

Still going to get the meningitis vaccine, the weird stuff seems to have no problem finding me.

We now just learned they are saying she also has encephalitis. If their first dx of bacterial meningitis is correct, then I wonder whether that is secondary encephalitis she actually has, which I understand can happen after another infection and is not transmissible like viral encephalitis.

We now just learned they are saying she also has encephalitis. If their first dx of bacterial meningitis is correct, then I wonder whether that is secondary encephalitis she actually has, which I understand can happen after another infection and is not transmissible like viral encephalitis.

Sorry to hear that. With my encephalitis, the IV meds knocked out the bat shit crazy impact overnight, but it took months to get all the way back to normal.

For those considering the meningitis vaccine, I got that and the pneumonia vaccine yesterday at CVS. The meningitis never needs a booster if given as an adult, and the pneumonia only every 5 years. There was no cost with insurance, same as getting the flu vaccine. One thing less to worry about.

I had an ID doctor in another State who very pro vaccinate, including MMR boosters as adults since immunity can be somewhat lost if your last booster was 20+ years ago, etc. My current ID doc not so much except flu and pneumonia.

It's just something I'd been meaning to do and the news just reminded me, not because I was afraid of an actual outbreak. Just do it once and never have to bother again, why not...?

The meningitis never needs a booster if given as an adult, and the pneumonia only every 5 years.

Are you sure about that?? I recall the meningococcal vaccine being effective for 3-5 years. Requiring another shot if still in a high risk environment. I received it in college due to an outbreak and a few times in the Army.Granted -- this was a few years back, so it may have changed, but I would check with the doc to be sure.

I, also, agree with Miss P -- there isn't a real need for this vaccine if you aren't in a high risk area. Typically that is a close quartered living situation -- like dorms and military barracks.

I, also, agree with Miss P -- there isn't a real need for this vaccine if you aren't in a high risk area. Typically that is a close quartered living situation -- like dorms and military barracks.

M

exactly -- originally the warning in NYC was even more specific reading: Any gay man or MSM (man who has sex with men), at least 18 years of age, regardless of HIV status, who has had sex with a man he met through a website (Manhunt, Adam 4 Adam, etc.), digital application (GRINDR, SCRUFF, etc.), a bar, or a party since September 1, 2012 or who plan on having such contact in the future are recommended to be vaccinated.

I recall seeing map of the five boroughs and you could see how it was grouped in distinct neighborhoods -- it was more as if you lived in downtown Brooklyn or Hell's Kitchen and hooking up on Grindr rather than a gay guy who lived and worked way out in Carnarsie or Kew Gardens.

Then later they expanded the warning to the entire state, but still only non-monagmous MSM who had had sex with someone from NYC.

Highly Lethal : I get itcasually transmissible : I get itCreates a 'community' outbreak when time to Hospital (time of infection to time you call the paramedics) is 24 h: I don't get it

The gay cancer thing, later renamed AIDS, is highly lethal, causally transmissible, but able to open shop because the time to Hospital is several orders of magnitude higher. That outbreak would not stop on its own.

If the time to Hospital is so short, can't we expect that the 'outbreak' will be under control in only just one Week End (regardless of vaccination)

This is where I hope that the scientifically minded would kindly shed some light on.

We now just learned they are saying she also has encephalitis. If their first dx of bacterial meningitis is correct, then I wonder whether that is secondary encephalitis she actually has, which I understand can happen after another infection and is not transmissible like viral encephalitis.

I believe encephalitis is a secondary condition that results from the primary infection. I believe that's how my doctor explained it to me when I was hospitalized with cryptococcal meningoencephalitis. The encephalitis part means there is brain swelling which is the painful aspect of it.

I did question my doctor about other meningitis vaccines and he's not convinced I need one and he tends to push vaccinations on everyone. My personal belief is that even the sluttiest amongst us aren't at any greater risk than the general population. It would have to be a perfect storm type of thing. The symptoms manifest so quickly, that someone with the infection probably wouldn't be out looking to get laid.

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If the first dose is given between 13 and 15 years of age, the booster should be given between 16 and 18. If the first dose is given after the 16th birthday, a booster is not needed.

Nope -- I know the difference between pneumonia and meningitis.

You MAY be confusing a lacking the need for a booster, with life long immunity. A "booster" is the second and third round of Hep B vaccine, meaning one shot isn't enough. I have had this vaccination at least 3 times that I can remember -- each required by a doctor, despite my vaccination history (the Army makes soldiers keep a vaccine history).Because this vaccine is only recommended when you are at high risk, most people never get it. IF they could give a single shot that ensured life-time immunity from a rapidly fatal, though rare, illness, they might make it more routine.

Now -- it's possible the formulation has been changed to give life-long immunity, but I doubt it.

I'm not trying to pick a fight -- but if someone reading this had a meningococcal vaccination years ago, and is currently in a high-risk setting -- I don't want them to have a false sense of security.

The paper in front of me lists both MCV4, the preferred vaccine for those 55 and under as well as MPSV4 which has been available since the 1970's and is the only meningococcal vaccine licensed for people over 55.

Adolescents get 2 doses, adolescents with HIV get 3, these are listed as a routine vaccination on the paperwork. Those over 16 don't need a booster as I previously quoted.

You can look at all of the vaccine information sheets on the link below, I don't think I misrepresented or misunderstood what it says.

I don't think what the Army does really counts for much honestly, and I don't mean that in a mean way; they just may have written a policy in the 70's and never changed it, or perhaps it's different now...

That info sheet doesn't mention lifelong immunity. These sheets are intended to tell you about what you are about to get to make an informed choice.

Not sure why you would think the Army would have outdated info on vaccines -- soldiers get more shots than most Americans, whenever they deploy overseas. I can attest to that from personal experience.

I read the pneumococcal sheet (PPSV) and it is written to sound like no more than 2 shots are needed, when every doctor I've had has said EVERY 5 years, if you fall into a group who should get it. So -- I'm not convinced that these sheets are telling the whole story.

Finally -- while I can't seem to locate my old Microbiology textbooks --- I seem to remember learning of the need for repeat vaccinations in my schooling (I worked in clinical labs for many years -- mainly Hematology, but Microbiology also)

So -- bottomline - people should rely on their doctor's advice and not a patient information sheet -- or, for that matter, advice received on an internet forum. Meningitis is nothing to fool with!

I am a tad confused on the timing of this. The link Miss P provided stated 3 men died. Today, this article says the Health Dept failed to report the 3 deaths. Are hospitals required to report meningitis diagnoses?

I am a tad confused on the timing of this. The link Miss P provided stated 3 men died. Today, this article says the Health Dept failed to report the 3 deaths. Are hospitals required to report meningitis diagnoses?

I think it's stating that it took 1-2 months for the LA DOH to report these deaths. They reported them on 2 April (and made their vaccination alert) even though evidently the earliest in this grouping was in February.

But I am not sure this is strange -- one case is cause for vaccinations, but a grouping of 3 in a short is. Plus you have to do investigations of the circumstances -- such as the person's sexuality and geographic activity, which in this case showed that it was clustered in West and North Hollywood for the three dead men in their 20's.

It all seems like a repeat of what was seen in NYC in 2012-13 and after a vaccination program in these areas it will die out over the next 6-12 months.

There's no cause for great alarm unless you live in LA, socialize in those areas a lot, or are planning a trip to WeHo next week. Los Angeles county is larger in population than 43 states -- shit happens. It's also 120 miles from Malibu to Lancaster -- if I was gay and lived in Malibu I would see no reason whatsoever to be vacinnated. Buena Park in Orange county is closer than Malibu to West Hollywood. I guess the question then is should Orange county's Dept. of Health issue a similar warning?

I have to disagree with you. All it take is for a person from one of these areas to travel and spread this. I work in an area where I come in close contact with gay men from both these areas. In my opinion I would have a discussion with your doctors and look at your individual risks. In my case my doctor thought that the random chance that I may come in contact with a person from on of these areas was enough for him to have me vaccinated.

"It is spread by close exposure to sneezing or coughing or direct contact with saliva or nose mucus -- though it's less contagious than influenza, the health department said. Activities associated with risk for the illness include smoking, close contact with an infected person such as kissing or sharing beverages or cigarettes, and living in group settings for prolonged periods."

"[Updated 8:50 p.m. April 3: Robert Bolan, the medical director at the L.A. Gay & Lesbian Center, said there is cause for concern in the gay community because the infection rate is higher in men who have sex with men and especially higher in those who are HIV positive. Bolan said it is unclear why the disease seems to affect gay men specifically, though the weakened immune systems of people who are HIV positive might make them more susceptible."

There is a huge difference between a person and his/her doctor making a decision for a vaccination and having a Public Health (county, city, state, or Federal) recommendation that a population get vaccinated.There needs to be a risk/benefit discussion -- as vaccination do not come without risks to some folks.

Plus -- is it me or does this whole "gay community is at risk" smack of the "Gay Plague" line of thinking. It isn't about who you are, it is about what you do. Plus, with meningitis, it isn't just a sexual liaison that could put you at risk -- so to single out the gay community certainly gives false security to the straight community.

Bottomline -- assess your own risk and tolerance for risk, talk to your doctor and act accordingly. Panic is certainly not warranted -- and stating "all it takes is for a person to travel and spread this" starts to smack of unwarranted panic. I mean, meningitis cases occur all the time -- so this "risk" always exists.

With the statistics, it would seem you'd have a better chance of getting hit by lightning, even if you live in NYC or L.A. I see it as a few cases out of tens of thousands to hundreds of thousands of gay men. A million altogether, in both cities?

Having said that, I know any infection could spread very quickly through the gay community. If the vaccine is safe (any vaccine really), then I always wonder why they just don't recommend it to everyone. Unless there was a higher percentage of adverse events than say with the flu vaccine, then why not just vaccinate everyone just in case. I'm sure those men who died never thought they would be the ones infected, as it would seem so very remote.

the vaccine is not cheap. $150 if I am correct. Appears to have been made mandatory if you to some regions (Saudi Arabia) and that has proven usefull

Cases seem to be very localized since, as mentionned earlier, infection to Hospital is only 24 h.

One thing is not clear to me: if Mr Gay A is at risk and gets vaccinated, he is protected. Is this protecting his family members or close ones ? Or should Mr Gay A extend the vaccination recommandation to his close ones ? Eric

Hence you think the CDC/NIH are being negligent by not recommending state-wide vaccinations in... oh -- New Hampshire?

Your arrogance is not funny. For your information I work the summers in Ogunquit ME where we see people from all over the country and the world come visit. The original poster was from Providence Town MA and is in a very similar type of gay tourist area like where I work in ME. When I raised the concern of meningitis with my doctor base on my contact that I may have with people from the NYC area over the summer of 2013 it was thought to be in my best interest to get vaccinate. For your information my doctor is Dr. Benjamin Davis with Massachusetts General and Harvard Medical School.

Do I think the CDC/NIH is being negligent by not recommending state-wide vaccinations in? Oh -- New Hampshire?

NoÖ

What I do think is that you are a being a bit ignorant when you state:

ďThere's no cause for great alarm unless you live in LA, socialize in those areas a lot, or are planning a trip to WeHo next week. Los Angeles county is larger in population than 43 states -- shit happens. It's also 120 miles from Malibu to Lancaster -- if I was gay and lived in Malibu I would see no reason whatsoever to be vacinnated.Ē

I would also agree with Mike when he says:

ďThere is a huge difference between a person and his/her doctor making a decision for a vaccination and having a Public Health (county, city, state, or Federal) recommendation that a population get vaccinated.There needs to be a risk/benefit discussion -- as vaccinations do not come without risks to some folks.

Plus -- is it me or does this whole "gay community is at risk" smack of the "Gay Plague" line of thinking. It isn't about who you are; it is about what you do. Plus, with meningitis, it isn't just a sexual liaison that could put you at risk -- so to single out the gay community certainly gives false security to the straight community.

Bottom-line -- assess your own risk and tolerance for risk, talk to your doctor and act accordingly. Panic is certainly not warranted -- and stating "all it takes is for a person to travel and spread this" starts to smack of unwarranted panic. I mean, meningitis cases occur all the time -- so this "risk" always exists.Ē

I've been trying to catch up with peeps and am astonished how this thread turned out. I wasted precious time reading through the whole damn thread and never saw some of the nefarious posts that justified resorting to demeaning.

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You simply don't declare any outbreak that only affects such a small, small, small segment of the population. It's expensive, usually not needed, and causes panic and distress.

We're having an epidemic of something here at OSU. measles, mumps, whatever. I have a nephew who's a junior there that we visit with. Should our entire community panic since he might be a carrier? LMFAO

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